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Sort out a problem with a payment

If you’re having problems or you haven’t received a payment from us, find out why and what you can do. You’ll see a reason code on your remittance advice that will give you more detail.

On this page

    How long we’ll take to pay your invoice

    If we haven’t paid you, check when you sent your invoice. You’ll usually get paid after:

    • eight working days if you’ve submitted your invoice online
    • 10 working days if you’ve submitted your invoice manually or emailed them.

    Invoices must meet Inland Revenue tax standards

    If your manual invoice doesn't meet Inland Revenue tax invoice standards, we can't accept the invoice and it will be declined. This will cause a hold up of your payment.

    Check the manual invoicing requirements

    Check the reason code on your remittance advice

    You can check your remittance advice to find out why we haven't paid you or where an invoice is partly paid. Each invoice line exception will show a reason code and description of why we're unable to pay in full. Eg 'NOC – no claim found'.

    If you've invoiced us online, you can view your remittance advice under the 'payment advice' tab.

    The most common reasons we might not have paid you:

    You've billed for a service that was provided more than 12 months ago. We don't pay for services supplied over a year ago unless there are exceptional circumstances as to why this was not billed earlier.

    What you can do

    Contact our provider helpline to discuss the circumstances of the late billing.

    There's no current approval for the service and it has been referred to the case manager to review.

    What you can do

    Wait for the case manager to review the request, at least five business days. The services are usually accepted or declined in this timeframe and your remittance advice is updated to reflect the outcome. If you haven't heard anything past this point, contact provider help to investigate.

    The client's age doesn't meet the criteria of the service being claimed. For example, billing an under-14 service code for a client who is 16 years old.

    What you can do

    Check to make sure you have the client's age logged correctly and reinvoice with the appropriate service code.

    The claimed service has appeared on an earlier invoice. This has been either previously paid, or accepted for payment. We'll usually provide details of the earlier invoice or payment.

    What you can do

    Check your records to ensure the details we've provided are correct. If there's a reason you're charging a second time for the service, please contact provider help to discuss further.

    The maximum number of hours approved for the claim have been used. For example, if you have the approval to supply two hours of a service, you've claimed those services and are now attempting to claim for time in addition to this.

    What you can do

    Contact the appropriate department or case manager to discuss further.

    The contract number supplied on the invoice or schedule is not held by the billing vendor.

    What you can do

    Check to see that you've supplied the correct contract number. You can't bill for service codes on contracts you don't hold. Contact provider help to make any adjustments or corrections if you've identified an error with the information you supplied. Otherwise, you'll need to reinvoice with an appropriate service code under a contract you hold or under a regulation contract.

    The maximum service price for the claim has been exceeded. This price cap is made up of the cumulative value of services rendered on the claim to a set value based on the contract.

    What you can do

    You'll need to contact the appropriate department or case manager to request approval for additional services.

    The maximum monetary figure approved for the claim has been used.

    What you can do

    Contact the appropriate department or case manager to discuss further.

    The GST amount claimed is incorrect or missing.

    What you can do

    Reinvoice for the services with the correct GST rate or with GST inclusive amounts.

    We don't cover the cost of replacement or repair for items still covered under warranty.

    What you can do

    The costs for replacement or repair should be taken up with the manufacturer or supplier.

    The injury resolved indicator has been activated on the claim. This happens when we believe the underlying injury has been treated and resolved.

    What you can do

    Approval is required to supply additional services on this claim. Please contact the appropriate department or case manager for approval. If you already have approval in place, please contact provider help to investigate payment release.

    The maximum number of services have been claimed.

    What you can do

    To provide additional treatments, you need to contact the appropriate department or case manager to request approval and a purchase order will be created.

    Usually this means you've invoiced us for a service multiple times on the same service date. For example, you're a GP who sees the same client twice in one day and you've invoiced us for those two consultations.

    What you can do

    If you see the MSD reason code and you invoiced us online, check your online invoicing records.

    If you invoiced us for two consultations for the same client in one day, you'll need to send us some evidence. This states why you needed to provide the second service on the same day.

    We have no prior approval for the service and date of service you're invoicing for. Or you didn't get prior approval for any treatment over the trigger limit.

    What you can do

    Check your purchase order to see what services we approved and the date range for these services. If it's not right, contact the recovery team or case owner who approved these services.

    If you're a specified treatment provider or hand therapist, you must provide services within the trigger limit. We can't pay for services over the injury limits without prior approval.

    Request prior approval for further treatment

    The claim number hasn't been supplied or is incorrect.

    What you can do

    Contact provider help with the correct claim number.

    This means either:

    • the ACC45 number you've quoted on your invoice is wrong
    • we haven't received an ACC45 claim form for the client's injury you're invoicing us for.

    What you can do

    Check the ACC45 claim form number against the one quoted on the invoice.

    Make sure you've sent us the ACC45 claim form. If you send these online, check your sent items. You don't need to invoice us again for this service. Once we have the ACC45 and accepted cover for the injury, we'll automatically make the payment.

    This reason code is used to provide customised information in your payment advice where no other reason code is suitable or fit for purpose.

    What you can do

    Check the information provided in the pay advice line, this will provide an indication of the reason for the decline or held service, ie "GST Number not listed on invoice".

    No provider ID was supplied with a service code that requires the provider of the service to be named.

    What you can do

    Contact provider help to supply the details for the provider of the service.

    The provider listed as supplying the service is not active on our system.

    What you can do

    Contact us to have the provider record activated.

    Email registrations@acc.co.nz

    Then contact provider help to review the service.

    We'd like you to double-check if there's an issue with the service code, dollar amount, or quantity being invoiced. This is usually due to the dollar amount not matching the quantity being claimed. For example, claiming two units but billing the dollar value of one unit.

    What you can do

    You can contact provider help to discuss the options available for amending the current schedule. Otherwise, this may need to be reclaimed with the appropriate corrections.

    The service has been billed at an incorrect regulation or contracted rate. This can happen after a price change on a contract or to the regulations.

    What you can do

    Resubmit the service at the correct regulation or contracted rate.

    The maximum period allowed for treatment has been exceeded. This is calculated from the date of the first treatment and may differ across contracts.

    What you can do

    To provide additional treatments outside of the treatment period, you need to contact the appropriate team or case owner to request approval and a purchase order may be created.

    The service date provided was prior to the date of the accident.

    What you can do

    Confirm the service date you've supplied, as we can't pay for services supplied prior to the accident date.

    The service code doesn't appear on the contract provided.

    What you can do

    Check the contract number you've supplied or the service code being used. If you've found an error with what you've submitted, can contact provider help. They may amend the contract info or service code as long as it's for an equal or lesser amount to what has been claimed.

    We don't pay for travel unless the primary service being supplied has been approved. Travel codes may be declined or held until the primary service has been accepted for payment.

    What you can do

    You'll need to address the reason the primary service has been declined or held first before the travel codes will be accepted for payment. Check your remittance advice for the primary service.

    Declined claims

    We can't pay for services if we’ve declined the claim. As there's no code for declined claims, you'll see a description instead. The most common are:

    Your patient chose to withdraw the claim.

    What you can do

    Please seek reimbursement for services provided directly from your patient.

    Cover was declined as cover criteria hasn't been met. Therefore we can't pay for services provided when the claim cover has been declined.

    Injuries we cover

    What you can do

    Contact provider help if the invoice is for a sensitive or work-related gradual process claim, including hearing loss. The team can sometimes consider payment in these instances.

    We can't cover your patient's injury because it wasn't caused by an accident.

    What you can do

    Please seek reimbursement for services provided directly from your patient.

    We didn't have all the information to be able to determine claim cover within the standard cover time frames.

    Injuries we cover

    How we make a decision on a claim

    What you can do

    Please seek reimbursement for services provided directly from your patient.

    We can't cover the claim for your patient, as there was no specific physical injury as a result of their accident.

    What you can do

    Please seek reimbursement for services provided directly from your patient.

    If we haven't made a decision on whether we cover an injury, we'll hold payment until a decision is made.

    If we accept cover for the injury, we'll pay you for services. If we decline the claim, we'll let your client know by decision letter.

    What you can do

    Please seek reimbursement for services provided directly from your patient when the claim is declined.

    Contact provider help if the invoice is for a sensitive or work-related gradual process claim, including hearing loss. The team can sometimes consider payment in these instances.

    We don't pay for services that should be for an Accredited Employer.

    What you can do

    Send the Accredited Employer your invoice. The remittance advice will have their contact details.

    We can't pay for services provided after we've declined a work-related gradual process claim, including hearing loss, unless they were purchased by ACC.

    We can pay for services before the declined date. A medical practitioner must have seen the client before you provided services.

    Injuries we cover

    How we make a decision on a claim

    What you can do

    Please seek reimbursement for services provided directly from your patient. If you have a purchase approval please contact our provider helpline to discuss payment release.

    Contact us

    If you have any questions, contact us:

    Phone 0800 222 070 (Monday to Friday, 7am - 7pm)
    Email providerhelpline@acc.co.nz

    Last published: 21 April 2021